| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
55,296 |
46,999 |
$2.73M |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
45,854 |
39,383 |
$2.11M |
| A4554 |
Disposable underpads, all sizes |
65,311 |
58,933 |
$1.78M |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
34,618 |
29,586 |
$1.73M |
| A4335 |
Incontinence supply; miscellaneous |
86,759 |
70,459 |
$1.60M |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
46,528 |
39,459 |
$1.59M |
| A4927 |
Gloves, non-sterile, per 100 |
110,906 |
90,180 |
$1.39M |
| T4541 |
Incontinence product, disposable underpad, large, each |
43,543 |
32,615 |
$1.20M |
| B4150 |
Enteral formula, nutritionally complete with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
15,063 |
12,249 |
$1.09M |
| E1399 |
Durable medical equipment, miscellaneous |
3,510 |
2,442 |
$981K |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
17,262 |
14,584 |
$977K |
| B4161 |
Enteral formula, for pediatrics, hydrolyzed/amino acids and peptide chain proteins, includes fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
2,052 |
1,276 |
$900K |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
8,396 |
7,337 |
$843K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
14,879 |
12,431 |
$786K |
| B4160 |
Enteral formula, for pediatrics, nutritionally complete calorically dense (equal to or greater than 0.7 kcal/ml) with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
3,904 |
3,774 |
$566K |
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
3,200 |
2,708 |
$515K |
| T4544 |
Adult sized disposable incontinence product, protective underwear/pull-on, above extra large, each |
5,125 |
3,818 |
$455K |
| B4152 |
Enteral formula, nutritionally complete, calorically dense (equal to or greater than 1.5 kcal/ml) with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
3,717 |
3,247 |
$440K |
| B4154 |
Enteral formula, nutritionally complete, for special metabolic needs, excludes inherited disease of metabolism, includes altered composition of proteins, fats, carbohydrates, vitamins and/or minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
4,165 |
3,521 |
$435K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
8,315 |
6,860 |
$401K |
| A4245 |
Alcohol wipes, per box |
45,827 |
39,737 |
$390K |
| A6250 |
Skin sealants, protectants, moisturizers, ointments, any type, any size |
38,875 |
34,503 |
$327K |
| T4525 |
Adult sized disposable incontinence product, protective underwear/pull-on, small size, each |
6,870 |
5,576 |
$323K |
| T4543 |
Adult sized disposable incontinence product, protective brief/diaper, above extra large, each |
2,754 |
2,027 |
$300K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
7,549 |
6,584 |
$257K |
| B4149 |
Enteral formula, manufactured blenderized natural foods with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
545 |
493 |
$241K |
| B4153 |
Enteral formula, nutritionally complete, hydrolyzed proteins (amino acids and peptide chain), includes fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
332 |
307 |
$234K |
| B9002 |
Enteral nutrition infusion pump, any type |
4,024 |
3,632 |
$234K |
| E0445 |
Oximeter device for measuring blood oxygen levels non-invasively |
3,125 |
2,957 |
$226K |
| T4540 |
Incontinence product, protective underpad, reusable, chair size, each |
9,664 |
6,894 |
$221K |
| A4624 |
Tracheal suction catheter, any type other than closed system, each |
1,620 |
1,316 |
$218K |
| E0465 |
Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube) |
381 |
337 |
$211K |
| S5199 |
Personal care item, nos, each |
15,800 |
14,043 |
$205K |
| E0466 |
Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) |
296 |
260 |
$169K |
| K0001 |
Standard wheelchair |
7,361 |
6,651 |
$166K |
| E0601 |
Continuous positive airway pressure (cpap) device |
3,070 |
2,731 |
$155K |
| E0255 |
Hospital bed, variable height, hi-lo, with any type side rails, with mattress |
2,590 |
2,198 |
$154K |
| T4534 |
Youth sized disposable incontinence product, protective underwear/pull-on, each |
1,414 |
1,344 |
$146K |
| B4088 |
Gastrostomy/jejunostomy tube, low-profile, any material, any type, each |
1,556 |
1,342 |
$141K |
| A4353 |
Intermittent urinary catheter, with insertion supplies |
324 |
253 |
$140K |
| B4034 |
Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
1,880 |
1,723 |
$132K |
| B9998 |
Noc for enteral supplies |
3,028 |
1,866 |
$131K |
| A5120 |
Skin barrier, wipes or swabs, each |
11,591 |
8,176 |
$117K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
4,083 |
3,868 |
$100K |
| E0471 |
Respiratory assist device, bi-level pressure capability, with back-up rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device) |
389 |
361 |
$97K |
| E0277 |
Powered pressure-reducing air mattress |
654 |
424 |
$95K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
3,846 |
3,583 |
$93K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
910 |
736 |
$76K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
1,237 |
1,195 |
$72K |
| E0630 |
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) |
1,402 |
1,255 |
$68K |
| A6402 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
3,389 |
2,790 |
$65K |
| T4521 |
Adult sized disposable incontinence product, brief/diaper, small, each |
1,140 |
848 |
$62K |
| E0570 |
Nebulizer, with compressor |
917 |
871 |
$61K |
| E1060 |
Fully-reclining wheelchair, detachable arms, desk or full length, swing away detachable elevating legrests |
1,000 |
895 |
$59K |
| A4629 |
Tracheostomy care kit for established tracheostomy |
884 |
798 |
$57K |
| E1235 |
Wheelchair, pediatric size, rigid, adjustable, with seating system |
433 |
395 |
$54K |
| B4155 |
Enteral formula, nutritionally incomplete/modular nutrients, includes specific nutrients, carbohydrates (e.g., glucose polymers), proteins/amino acids (e.g., glutamine, arginine), fat (e.g., medium chain triglycerides) or combination, administered through an enteral feeding tube, 100 calories = 1 unit |
413 |
350 |
$52K |
| B4100 |
Food thickener, administered orally, per ounce |
1,079 |
813 |
$46K |
| T4530 |
Pediatric sized disposable incontinence product, brief/diaper, large size, each |
578 |
566 |
$45K |
| E0600 |
Respiratory suction pump, home model, portable or stationary, electric |
2,036 |
1,817 |
$44K |
| E0443 |
Portable oxygen contents, gaseous, 1 month's supply = 1 unit |
1,954 |
1,019 |
$44K |
| E0619 |
Apnea monitor, with recording feature |
361 |
287 |
$43K |
| A4357 |
Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each |
1,930 |
1,461 |
$40K |
| E0470 |
Respiratory assist device, bi-level pressure capability, without backup rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device) |
384 |
356 |
$36K |
| E0163 |
Commode chair, mobile or stationary, with fixed arms |
560 |
545 |
$31K |
| K0006 |
Heavy duty wheelchair |
491 |
428 |
$30K |
| A6197 |
Alginate or other fiber gelling dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., each dressing |
67 |
65 |
$29K |
| A9900 |
Miscellaneous dme supply, accessory, and/or service component of another hcpcs code |
1,620 |
899 |
$29K |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
1,780 |
1,619 |
$28K |
| E0550 |
Humidifier, durable for extensive supplemental humidification during ippb treatments or oxygen delivery |
491 |
410 |
$27K |
| A4349 |
Male external catheter, with or without adhesive, disposable, each |
906 |
656 |
$26K |
| A4450 |
Tape, non-waterproof, per 18 square inches |
1,012 |
853 |
$24K |
| A6212 |
Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing |
106 |
96 |
$24K |
| A7048 |
Vacuum drainage collection unit and tubing kit, including all supplies needed for collection unit change, for use with implanted catheter, each |
23 |
12 |
$23K |
| A7526 |
Tracheostomy tube collar/holder, each |
1,256 |
949 |
$22K |
| A7508 |
Housing and integrated adhesive, for use in a tracheostoma heat and moisture exchange system and/or with a tracheostoma valve, each |
369 |
329 |
$21K |
| A4414 |
Ostomy skin barrier, with flange (solid, flexible or accordion), without built-in convexity, 4 x 4 inches or smaller, each |
360 |
290 |
$20K |
| A4351 |
Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, or silicone elastomer, etc.), each |
157 |
141 |
$19K |
| A7002 |
Tubing, used with suction pump, each |
1,597 |
1,353 |
$19K |
| E0565 |
Compressor, air power source for equipment which is not self-contained or cylinder driven |
875 |
833 |
$19K |
| A4623 |
Tracheostomy, inner cannula |
227 |
205 |
$18K |
| K0007 |
Extra heavy duty wheelchair |
182 |
165 |
$17K |
| K0003 |
Lightweight wheelchair |
413 |
361 |
$16K |
| A4322 |
Irrigation syringe, bulb or piston, each |
518 |
438 |
$16K |
| A4213 |
Syringe, sterile, 20 cc or greater, each |
362 |
295 |
$15K |
| E0240 |
Bath/shower chair, with or without wheels, any size |
281 |
160 |
$14K |
| E1392 |
Portable oxygen concentrator, rental |
870 |
726 |
$13K |
| E0776 |
Iv pole |
1,231 |
1,124 |
$13K |
| A4409 |
Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, 4 x 4 inches or smaller, each |
162 |
128 |
$13K |
| A4425 |
Ostomy pouch, drainable; for use on barrier with non-locking flange, with filter (2 piece system), each |
233 |
196 |
$12K |
| A4452 |
Tape, waterproof, per 18 square inches |
302 |
271 |
$11K |
| A7520 |
Tracheostomy/laryngectomy tube, non-cuffed, polyvinylchloride (pvc), silicone or equal, each |
270 |
240 |
$10K |
| A5063 |
Ostomy pouch, drainable; for use on barrier with flange (2 piece system), each |
272 |
206 |
$9K |
| A6216 |
Gauze, non-impregnated, non-sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
487 |
468 |
$8K |
| E0603 |
Breast pump, electric (ac and/or dc), any type |
218 |
82 |
$8K |
| T4532 |
Pediatric sized disposable incontinence product, protective underwear/pull-on, large size, each |
67 |
65 |
$8K |
| A4338 |
Indwelling catheter; foley type, two-way latex with coating (teflon, silicone, silicone elastomer, or hydrophilic, etc.), each |
255 |
223 |
$6K |
| A4358 |
Urinary drainage bag, leg or abdomen, vinyl, with or without tube, with straps, each |
631 |
386 |
$6K |
| A4456 |
Adhesive remover, wipes, any type, each |
315 |
283 |
$6K |
| A5061 |
Ostomy pouch, drainable; with barrier attached, (1 piece), each |
105 |
87 |
$5K |
| A7000 |
Canister, disposable, used with suction pump, each |
491 |
431 |
$5K |
| A7010 |
Corrugated tubing, disposable, used with large volume nebulizer, 100 feet |
286 |
270 |
$5K |
| T4529 |
Pediatric sized disposable incontinence product, brief/diaper, small/medium size, each |
63 |
57 |
$4K |
| E0156 |
Seat attachment, walker |
258 |
252 |
$4K |
| E0245 |
Tub stool or bench |
132 |
130 |
$4K |
| A9270 |
Non-covered item or service |
633 |
541 |
$4K |
| A4406 |
Ostomy skin barrier, pectin-based, paste, per ounce |
308 |
262 |
$4K |
| A4618 |
Breathing circuits |
207 |
191 |
$3K |
| A6446 |
Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to three inches and less than five inches, per yard |
270 |
260 |
$2K |
| E0971 |
Manual wheelchair accessory, anti-tipping device, each |
29 |
27 |
$2K |
| A4385 |
Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, without built-in convexity, each |
54 |
42 |
$1K |
| A7525 |
Tracheostomy mask, each |
367 |
344 |
$1K |
| A4371 |
Ostomy skin barrier, powder, per oz |
281 |
245 |
$1K |
| A4311 |
Insertion tray without drainage bag with indwelling catheter, foley type, two-way latex with coating (teflon, silicone, silicone elastomer or hydrophilic, etc.) |
71 |
65 |
$959.21 |
| A4332 |
Lubricant, individual sterile packet, each |
42 |
40 |
$936.16 |
| A7013 |
Filter, disposable, used with aerosol compressor or ultrasonic generator |
416 |
359 |
$865.08 |
| A7015 |
Aerosol mask, used with dme nebulizer |
1,036 |
978 |
$862.04 |
| A4670 |
Automatic blood pressure monitor |
33 |
12 |
$656.44 |
| A7012 |
Water collection device, used with large volume nebulizer |
161 |
151 |
$489.10 |
| K0739 |
Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes |
27 |
26 |
$450.41 |
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
13 |
12 |
$444.38 |
| A7007 |
Large volume nebulizer, disposable, unfilled, used with aerosol compressor |
77 |
64 |
$282.28 |
| E0978 |
Wheelchair accessory, positioning belt/safety belt/pelvic strap, each |
16 |
15 |
$203.11 |
| A4402 |
Lubricant, per ounce |
13 |
12 |
$70.93 |
| A4616 |
Tubing (oxygen), per foot |
50 |
46 |
$66.40 |
| A4244 |
Alcohol or peroxide, per pint |
14 |
14 |
$55.41 |